Advancements in Transcatheter Aortic Valve Implantation: A Focused Update.
Niccolò CiardettiFrancesca CiattiGiulia NardiFrancesca Maria Di MuroPierluigi DemolaEdoardo SottiliMiroslava StolcovaFrancesca RistalliAlessio MattesiniFrancesco MeucciCarlo Di MarioPublished in: Medicina (Kaunas, Lithuania) (2021)
Transcatheter aortic valve implantation (TAVI) has become the leading technique for aortic valve replacement in symptomatic patients with severe aortic stenosis with conventional surgical aortic valve replacement (SAVR) now limited to patients younger than 65-75 years due to a combination of unsuitable anatomies (calcified raphae in bicuspid valves, coexistent aneurysm of the ascending aorta) and concerns on the absence of long-term data on TAVI durability. This incredible rise is linked to technological evolutions combined with increased operator experience, which led to procedural refinements and, accordingly, to better outcomes. The article describes the main and newest technical improvements, allowing an extension of the indications (valve-in-valve procedures, intravascular lithotripsy for severely calcified iliac vessels), and a reduction of complications (stroke, pacemaker implantation, aortic regurgitation).
Keyphrases
- aortic valve replacement
- transcatheter aortic valve implantation
- aortic stenosis
- aortic valve
- ejection fraction
- transcatheter aortic valve replacement
- left ventricular
- coronary artery
- pulmonary artery
- end stage renal disease
- atrial fibrillation
- chronic kidney disease
- coronary artery disease
- electronic health record
- metabolic syndrome
- peritoneal dialysis
- early onset
- brain injury
- mitral valve
- deep learning
- aortic dissection
- skeletal muscle
- patient reported
- subarachnoid hemorrhage
- blood brain barrier
- machine learning